Individual provider Active NPI

Travis Ptomey, DC

  • Chiropractor
  • Boulder, CO
National Provider Identifier
1558390609
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5194 Issued in CO
Practice address
3775 Iris Ave
Ste 1a
Boulder, CO 80301-2043
Phone
(303) 440-8084
NPI assigned
Jul 1, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5194 CO Primary

Addresses

Primary practice location

3775 Iris Ave
Ste 1a
Boulder, CO 80301-2043

Mailing address

3775 Iris Ave
Ste 1a
Boulder, CO 80301-2043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5194COMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1558390609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 IRIS AVE",
            "address_2": "STE 1A",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 IRIS AVE",
            "address_2": "STE 1A",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012043",
            "telephone_number": "303-440-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PTOMEY",
        "first_name": "TRAVIS",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.